European Journal of Clinical Pharmacology

, Volume 73, Issue 2, pp 241–248 | Cite as

Antiepileptic drug use in Italian children over a decade

  • Daria Putignano
  • Antonio Clavenna
  • Rita Campi
  • Angela Bortolotti
  • Ida Fortino
  • Luca Merlino
  • Aglaia Vignoli
  • Maria Paola Canevini
  • Maurizio Bonati
Pharmacoepidemiology and Prescription

Abstract

Purpose

The aim of the study was to evaluate prescription profiles of antiepileptic drugs (AEDs) and to assess hospitalizations and specialist visits in pediatric patients with epilepsy.

Methods

The data sources were administrative health databases of Italy’s Lombardy Region, which collect prescriptions for drugs, diagnostic tests, specialist visits, and hospital discharge forms. All patients aged 0–16 years with at least seven AED (group N03A of the International Anatomical Therapeutic Chemical Classification) prescriptions over two consecutive years between 2003 and 2010 were identified and classified as prevalent or incident cases (no prescriptions in two previous years). The first prescription to incident cases was analyzed. For each incident case, drug prescriptions, specialist visits, diagnostic tests, and hospitalizations in the 24 months following the first (index) prescription were monitored.

Results

A total of 6527 incident cases (5.4/10,000 person-years, 95% CI 5.4–5.5) were identified. Valproic acid and carbamazepine were the most prescribed drugs (65.9 and 15.0%, respectively). The use of newer AEDs increased over time. In the 24-month observation period, 74% of incident cases continued the treatment with the index AED. The percentage of cases who changed therapy was higher in preschoolers (34%) and decreased with age. In all, 21% of incident cases were hospitalized for epilepsy and 86% had a specialist visit in the 24 months after the first AED prescription.

Conclusions

In conclusion, older AEDs, particularly valproic acid, remained the first therapeutic approach to pediatric epilepsy in Italy. For three quarters of cases, the initial AED treatment was likely effective and well tolerated.

Keywords

Drug utilization Prescription Anticonvulsants Epilepsy Pharmacoepidemiology 

Supplementary material

228_2016_2168_MOESM1_ESM.docx (13 kb)
Supplementary Table 1(DOCX 12 kb)
228_2016_2168_Fig3_ESM.gif (61 kb)
Supplementary Figure s1

(GIF 61 kb)

228_2016_2168_MOESM2_ESM.tif (47 kb)
High Resolution (TIFF 47 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Laboratory for Mother and Child Health, Department of Public HealthIRCCS—Istituto di Ricerche Farmacologiche “Mario Negri”MilanItaly
  2. 2.Lombardy Region, Region Health MinistryMilanItaly
  3. 3.Epilepsy Center, Health Sciences DepartmentUniversità degli Studi di Milano, San Paolo HospitalMilanItaly

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